causes of peristomal skin problems:
M: Mechanical trauma from the ostomy equipment and skin stripping
I: Infection (bacterial and fungal)
N: Noxious chemical and irritants including strong alkaline, feces, or urine
D: Diseases of the skin that are common in persons with ostomies, such as pyoderma gangrenosum, psoriasis, and so on
S: Skin allergens
Silicones are polymers that include silicone together with carbon, hydrogen, oxygen. These are applied to the peristomal skin.
Zinc oxide powder is an inorganic compound that is insoluble in water. It is applied generously to skin. It ma interfere with activity of ionic silver.
Acrylates form a protective interface on skin attachment sites. They are sprayed or wiped on skin sparingly. Allergy is uncommon.
Hydrocolloid wafers consists of a backing with carboxymethylcellulose as the filler, water-absorptive components, such as gelatin and pectin (commercial gelatin desserts), and an adhesive. Window frame the stoma to prevent recurrent stripping of skin. Allergies have been reported from some colophony-related adhesives that are associated with some hydrocolloid dressings
These reddish-brown and gritty deposits produce a localized inflammatory change that resembles the wart virus clinically and is referred to as false wartlike lesions (pseudoverrucous lesions [Figure 2]) or
pseudoepitheliomatous hyperplasia.Other signs and symptoms may include localized pain, erythema, or a loss of the superficial epidermis, with the remaining epidermis forming the base (erosion).This condition is mainly caused by improper skin barrier/pouch with an opening that is too large for the stoma, leading to urine leakage around the peristomal
skin.Treatment is directed at the specific problem as outlined in Table 3. Other strategies may entail the use of a urostomy pouch that has a 1-way valve to prevent retrograde flow of urine, a convex pouching system for uneven peristomal skin or recessed stomas, and proper sizing of skin barrier and pouch, so peristomal skin is not chronically overexposed to effluent.